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MultifidusMusculus multifidus spinae

Series of short, deep muscle bundles filling the groove beside the spinous processes from the sacrum to C2 that extend and steady each segment of the spine.

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LatinMusculus multifidus spinae
Origin
  • Sacral region: back of the sacrum, medial surface of the PSIS, posterior sacroiliac ligaments and the erector spinae aponeurosis
  • Lumbar region: mammillary processes
  • Thoracic region: transverse processes
  • Cervical region: articular processes of C4–C7
Insertion
  • Spinous processes of the vertebrae two to four levels above the origin
Action
  • Both sides: extend the spine and steady each spinal segment
  • One side: laterally flexes the spine to the same side
  • One side: rotates the trunk so the front turns to the opposite side
NervePosterior (dorsal) rami of the spinal nerves (Segmental, at each level of the spine)
NameLatin multifidus, 'split into many parts'; it is made of many small bundles.

Palpation

  1. Client prone with a pillow under the abdomen to flatten the lumbar curve; stand beside the table.
  2. Place the fingertips in the groove right beside the lumbar spinous processes, medial to the erector spinae columns.
  3. Sink in slowly; multifidus is the dense tissue filling the groove, thickest over the sacrum and lower lumbar spine.
  4. Ask the client to lift one leg a few centimetres off the table; feel the tissue in the groove tighten.

Landmarks: Sacrum · Posterior superior iliac spine

Multifidus lies under Erector spinae, right next to the spinous processes. You reach it by working slowly into the groove between the spine and the erector columns. It is thickest over the Sacrum and lower lumbar spine. Research links changes in the lumbar multifidus (wasting and fatty change) with low back pain. That is why it comes up often in remedial and rehabilitation work.

To tell it from the erectors, stay close to the spine. The erectors are the larger columns lateral to the groove; multifidus is the deeper, denser layer right next to the spinous processes. Gray’s (1918) says its longest bundles span three or four vertebrae, while Wikipedia says four.

Techniques

  • Circular friction — Small circles made with the finger or thumb pads that move the skin over the deeper tissue without sliding, to work a specific spot.
  • Compression — Pressing straight down into a muscle with the palm, fist or forearm, holding briefly, then releasing and moving on.
  • Trigger point pressure release — Sustained thumb or finger pressure on a tender spot within a taut band of muscle, held until the client reports the discomfort easing, then slowly released.

Works with

  • Erector spinae — Three long columns of muscle (iliocostalis, longissimus and spinalis) running beside the spine from the sacrum to the skull that extend and side-bend the back and hold the trunk upright.
  • External oblique — Broad, outermost muscle of the side of the abdomen that flexes, side-bends and rotates the trunk to the opposite side.

Opposes

  • Rectus abdominis — Long, strap-like muscle running vertically down the front of the abdomen that flexes the trunk and helps compress the abdomen.

Sources

  1. Wikipedia, Multifidus muscle
  2. Gray's Anatomy (1918), IV. Myology 6a: The Deep Muscles of the Back (Public domain; Bartleby edition read via the Internet Archive.)
  3. Gray's Anatomy (1918), IV. Myology 6b: The Suboccipital Muscles (actions of the multifidus) (Public domain; Bartleby edition read via the Internet Archive.)